The other group of patients reduced residual secreting insulin is only when glucose stimulation, rather than argininom that indicate a decline in sensitivity glyukoretseptorov b-kletok to occupy. The portion of these patients insulinoterapii appointment for a short period restores sensitivity and allows glyukoretseptorov revisit saharosnizhayuschey oral therapy. Secondary resistance to the PSM can be caused by the worsening of opportunistic diseases. After cupping these states effectiveness PSM can recover. In some cases, there is no true secondary resistance to the PSM, and the deterioration of their impact as a result of the failure of a diet. Always be mindful of the risk gipoglikemicheskih reactions using SAP and warn patients of the need to wear a legkousvoyaemyh carbohydrates. Hypoglycaemia is more than incidental, but the direct effect of SAP, but showed the wrong dose or recruiting violation diet. A feature gipoglikemy caused by PSM (unlike most ｫ insulinovyh ｻ gipoglikemy) is their prolongirovannost by a long period of half of these agents, especially in old age. Therefore, following the successful launch of the gipoglikemii, it nevertheless can recur within 12-72 hours. Side effects in the application of PSM mostly minor. They usually appear during the first 2 months from the beginning of therapy and dispepticheskimi disorders manifest in the form of nausea, sometimes vomiting, pain in epigastrii, feeling metallic taste in his mouth. Much less commonly more severe side effects that require dose reduction or complete abolition of drugs. This skin allergic reactions, leyko and thrombocytopenia, agranulotsitoz, Hemolytic Anemia, a toxic liver and kidney failure. Side-effects PSM should also include an increase in weight, but the effects can be minimized or prevented with proper diet. Biguanidy Products of this group do not alter the secretion of insulin, but in the presence of the latter increased peripheral glucose disposal of tissues.
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